Eastpointe explains changes to service

Eastpointe has to comply with budget constraints imposed by the state, but there might be creative ways to do it, director Ken Jones told a group of parents and providers Thursday night during a public forum at Wayne Center.

One of four events scheduled in Eastpointe's coverage area -- Duplin, Sampson, Lenoir and Wayne counties -- purpose was to explain the state's cuts and their impact on local programs.

Eastpointe stands to lose $2.7 million in state funding in the upcoming year, Jones said.

"We knew there would be cuts but did not know how they would play out," he said. What started out as an anticipated 15-22 percent cut rose to 27 percent when the governor requested an additional 5 percent be cut for the next fiscal year.

"Basically, we have to pull together a budget that now is from 20 to 27 percent less than what we had planned for," Jones said. "Some programs got hit harder than others. Federal programs, some of those, we can't touch. Programs that served people across the state and we manage the funds, those dollars are cut differently."

Jones stressed that the cuts were imposed by the state and not through any internal decisions by Eastpointe.

"We are more of a management company, almost like a managed care organization for the state dollars," he said.

In the four-county region, where the population is estimated around 293,000, Eastpointe serves 10,000 clients, Jones said.

"What we do is much bigger than it looks like on the budget," he explained. "Medicaid revenues that come through the four counties go up to around $40 million."

Although a separate issue, Medicaid cuts will also impact Eastpointe services. The biggest area, Jones said, will be in community support services.

"This service is effective immediately," he said. "If anyone gets into this service, they have to have a discharge plan. Jan. 1, 2010, no new consumers can be admitted to the program."

That's a major hit, Jones said, explaining that two years ago, 80 percent of people being served received support from that program.

Whether there will be a replacement remains to be seen, Jones said.

"That's going to be defined by the state, hopefully, and it will be submitted before Jan. 1, but that's something that's out of Eastpointe's control," he said.

Much like everything else surrounding the budget, he added.

"This is a decision that came through legislation and now the division is having to deal with it," Jones said.

Among the state-funded services affected by the cuts are administrative funds, which account for $201,594 for Eastpointe.

"Basically, we're freezing positions, especially our clinical positions this year because there are so many people moving through the system, and I think we're going to have to do everything possible to make sure no one falls through the cracks," Jones said. "It's going to be difficult all across the board."

There are some areas Eastpointe will keep constant, such as training programs for youths, which have proven to be effective prevention measures "that would keep some of our kids from taxing the system," Jones said.

While efforts will be made to make the budget cuts manageable, local help has been provided. Eastpointe's board of directors decided to make up $1 million in the fund balance and another $1.4 million came in from the county commission.

"Looking at our county funds -- walk-in clinics, transportation, indigent care, hospital -- this is skyrocketing," Jones said. "Cherry Hospital has sized down, and we have had to contract with private hospitals (including Wayne Memorial). Cherry Hospital now services six additional counties, and they have sized down."

Such care is very expensive, Jones pointed out -- about $750 a day.

"County commissioners have contributed very well and added to this," he said. "We're probably one of the only LME's (local management entities) that received additional funding," he said.

Eastpointe will continue to update providers of the cuts, and is taking suggestions on how to serve consumers more efficiently, Jones said.

One of the most immediate steps that will be taken is to move clients from one- to two-bed group homes to three-, four-, five- and six-bed group homes, Jones said. Other proposals include cuts to authorized services, such as reducing developmental therapy from six to four hours a week; reducing adult day vocational program hours from six to four hours a day; reducing targeted case management from five to four hours a week; and reducing community support team from eight to six hours a month.

Areas where there will be no change include respite, independent living, group living low and moderate, individual, group and family therapies, psychiatric, medication and psychological evaluations, multi-systemic therapy and emergency services.

Hopefully, Jones said, the public forums will elicit suggestions that can be included in the proposal Eastpointe will submit to the state.

"They will either tell us it's acceptable or it's not," he said, adding, "I did everything that I could to keep these cuts from happening, and I think that a lot of people did. But the cuts came down anyway and they had to come from somewhere. Unfortunately, it seems that we took a major hit, the mental health system did."

One example of "putting heads together to use resources more efficiently" is already expected to save Eastpointe a potential $43,000.

"We received an idea from parents who have children with autism," he said. "Parents found a provider willing to make a commitment to do a program that serves 10 kids three hours a week."

The price tag for serving those 10 children with developmental therapy for a year would likely have been $52,000. Instead, it came to about $9,000, Jones said.

"That was one example of how we were able to save money," he said. "I hope that we can come up with some things like that."

He asked that providers and audience members consider other suggestions and contact his office.

Three other public forums are planned this month -- Oct. 6 at Eastpointe Kinston office; Oct. 8 at Eastpointe Beaulaville office; and Oct. 12 at Sampson County Community College. Sessions are held from 6 to 7:30 p.m.